Metronidazole

Metronidazole, often sold under many brand names like Flagyl and Zidoval, is an antibiotic used to treat many different bacterial infections. These include several STIs, bacterial vaginosis, skin infections, infections of the gastrointestinal tract and across the body.

It is available as tablets as well as topical treatment (in the form of a gel or cream) or suppositories. You can also receive Metronidazole by injection via an intravenous infusion from a hospital for severe infections. What type of Metronidazole you take will depend on the nature of your infection and your preference.

At HealthExpress, you can purchase Metronidazole gel or tablets for the treatment of bacterial vaginosis or the STI trichomoniasis (trichomonas vaginalis).

What is Metronidazole used for?

Metronidazole has a wide variety of uses and can treat many different types of bacterial infections including:

• bacterial vaginosis (BV)
• trichomoniasis - an STI
• rosacea
• helicobacter pylori infection (also known as H. pylori) which is the most common cause of stomach ulcers (peptic ulcers)
• giardiasis (infection in the small intestine)
• pelvic inflammatory disease (PID)
• gum and tooth infections (dental abscess)
• parasitic (protozoa) infections, such as amoebiasis
• infections caused by anaerobic bacteria (e.g infected wounds or abscesses)

Any other use besides bacterial vaginosis or trichomoniasis, however, will have to be prescribed by your primary doctor.

Metronidazole is an antibiotic, and works by preventing the bacteria from spreading so your body can fight off the infection.

The drug belongs to a class of antibiotic known as nitroimidazole antimicrobials alongside tinidazole. It works by permeating bacterial cells, interfering with their DNA. This action prevents bacteria from duplicating so that it cannot spread; this helps your body's defences to remove the infection from your system.

As your body fights the infection, symptoms may begin to clear within a couple of days. However, as with all antibiotic treatments, you should continue treatment for as long as the doctor has prescribed. Otherwise, you risk the infection returning. For bacterial vaginosis or trichomoniasis, a course generally lasts for 5-7 days. For rosacea, it can be for between 6 weeks and 4 months.

Metronidazole tablets

The dose of Metronidazole tablets is 400 mg, but the course of treatment will depend on the severity of the infection and what caused it. When taking this medication to treat bacterial vaginosis (BV) and trichomoniasis:

• one 400 mg tablet should be taken twice a day, over 7 days
• you should preferably take Metronidazole with food
• it should be swallowed whole with water, not chewed or broken
• if you forget to take Metronidazole, take the dose as soon as you remember and continue as normal, unless it is nearly time for your next dose
• do not take two doses at once
• if you take more Metronidazole than you should, seek emergency medical attention, even if you feel fine

It is always important that you complete a course of antibiotics, even if the infection appears to have cleared or you start to feel better. If you stop taking it, the infection could return and eventually become more resistant to treatment.

You should not drink any alcohol during treatment.

Metronidazole gel

Metronidazole gel (Zidoval) is available to treat bacterial vaginosis. It is applied intravaginally using a disposable applicator. One applicatorful (5g) should be administered daily for 5 days.

A full guide on how to administer the treatment with diagrams is available in the patient information leaflet, however a brief guide is as follows:

1. Wash your hands thoroughly before administering and use a fresh applicator each time.
2. When opening the tube for the first time, pierce the foil seal with the pointed end of the cap.
3. Fill the applicator by screwing the open end of the applicator onto the tube, squeeze the tube gently until the applicator barrel is full.
4. Get into a comfortable position and gently insert the applicator into the vagina as far as it will comfortably go.
5. Slowly push the plunger down into the applicator to release the gel and continue pressing down until the plunger stops.
6. Remove the applicator from the vagina and dispose of it immediately.

You should use the gel for the entire course of treatment, do not stop unless you have been advised to do so, even if your symptoms improve.

If you miss a dose, apply the gel as soon as you remember. However, if it is nearly time for your next dose, wait until your next scheduled dose.

Do not take two doses at once. You should not take more than one applicatorful a day. If you take more than you should, seek immediate medical advice even if you feel fine.

Side effects of Metronidazole are considerably rare. However, it’s still important to familiarise yourself so you can treat any adverse effects straight away.

Some common side effects include:

• diarrhoea
• constipation
• nausea
• vomiting or stomach pain
• unpleasant or metallic taste in the mouth
• loss of appetite
• vaginal thrush
• skin reaction (such as itching, redness, burning or stinging)
• unusual feeling on the tongue
• dry skin

Rarer side effects include:

• drowsiness
• headache
• double vision
• joint pain
• jaundice (yellowing of the skin and eyes)
• muscle cramps
• dark urine
• swelling of the vulva
• changes to your menstrual period

If you do experience any serious side effects (e.g any swelling or breathing difficulties symptomatic of an allergic reaction) or symptoms worsen, please speak to a healthcare professional as soon as possible.

For a comprehensive list of side effects, please read through the patient leaflet at the bottom of this page.

Metronidazole is generally safe for most people to take. However, it may not be safe for you to use Metronidazole if you have:

• had an allergic reaction to Metronidazole or any of the other ingredients
• liver disease
• kidney problems
• a stomach or intestinal disease
• a blood cell disorder, such as anaemia or leukopenia
• epilepsy or a nerve disorder
• an inflammatory bowel disease like Crohn’s disease

Metronidazole should only be used during pregnancy and breast-feeding if deemed absolutely necessary, as small traces of Metronidazole have been found in breast milk. Speak to your doctor before taking it.

During the consultation stage of your order, you should mention any current or past conditions; this is so our doctors can identify any risks in prescribing this medication.

There are also certain drug interactions that can occur when taking Metronidazole with other medicines, so you must notify your prescriber of any medications you currently take including over-the-counter and prescription drugs; herbal supplements and recreational drugs.

People who take the following medicines should exercise particular caution:

• blood-thinning tablets (anticoagulants) e.g warfarin
• lithium - a mood stabiliser
• medicines for epilepsy e.g phenobarbital or phenytoin
• cancer medicines
• ciclosporin - prevents organ rejection after a transplant
• disulfiram - used to treat alcoholism

If you’re not sure if any of the above apply to you, speak to your doctor before taking this medicine.

It’s important that you do not drink any alcohol whilst taking Metronidazole. As it is an antibiotic, it can cause some side effects such as nausea, headaches and dizziness.

You should notify any previous sexual partners that you have been diagnosed with trichomoniasis as it is an infectious disease and they may also require treatment.

In rare cases, prolonged use of Metronidazole has been associated with peripheral neuropathy, a condition of the nervous system where nerves are damaged, resulting in nerve pain. However, incidence is low and only associated in cases where the drug is used in high doses and for more than 4 weeks.

Please consult your doctor if you experience any sudden or persistent pain whilst taking this medication.

You can purchase Metronidazole gel and tablets here at HealthExpress for the treatment of bacterial vaginosis and trichomoniasis. All you have to do is fill out a short online consultation form that is all online and reviewed by one of our UK registered doctors. Once you have been approved for treatment, your treatment will be sent discreetly right to your front door with free next-day delivery.